Medicare 101
Your complete, plain-English Medicare guide
New to Medicare? Start here. Medicare has four parts — A, B, C, and D. Below are the basics, then dig into any topic.
Part A — Hospital
Inpatient hospital, skilled nursing, hospice. Usually premium-free if you worked 10+ years.
Part B — Medical
Doctor visits, outpatient care, preventive services. Monthly premium set by income.
Part C — Advantage
A private all-in-one alternative bundling A, B, and usually D, often with extras.
Part D — Drugs
Prescription drug coverage, with a 2026 out-of-pocket cap of about $2,100.
All Medicare 101 articles
What Is Medicare?
Medicare is federal health insurance for people 65+ and some younger people with disabilities. Here's how the four parts fit together.
Medicare vs Medicaid
Medicare is age-based federal insurance; Medicaid is income-based. Some people qualify for both. Here's how they differ.
Medicare Eligibility
Most people qualify for Medicare at 65. Some younger people with disabilities qualify earlier. Here's how to know.
Medicare Enrollment Periods
IEP, AEP, and SEPs — the windows to enroll in or change Medicare, and how to avoid penalties.
How to Enroll in Medicare
A simple step-by-step for enrolling in Medicare at 65 — and how a local agent makes it painless.
Understanding Medicare Part D
How Part D drug coverage works, the 2026 $2,100 cap, formularies, and the late-enrollment penalty.
Medicare for Veterans
How VA benefits and Medicare work together, and why many veterans still enroll in Part B.
Medicare Costs Breakdown
Premiums, deductibles, and out-of-pocket numbers that matter for 2026 — in plain English.
Getting-started questions
Is Medicare free?
Not entirely. Part A is usually premium-free if you or your spouse paid Medicare taxes for at least 40 quarters (about 10 years). Part B always carries a monthly premium, set by the government and higher for upper incomes. Medicare Advantage and Part D plan premiums vary — some Advantage plans have a $0 plan premium, but you still pay your Part B premium and any copays or deductibles. (Verify current figures on Medicare.gov.)
Is Medicare the same as Medicaid?
No. Medicare is federal health insurance based mainly on age — most people qualify at 65 regardless of income. Medicaid is a joint federal-and-state program based on limited income and resources. The names sound alike, but they're separate. Some people qualify for both at once, which is called being "dual-eligible" and can unlock additional help with costs. We can check which programs you may qualify for.
What are the four parts of Medicare in simple terms?
Part A is hospital coverage, Part B is doctor and outpatient coverage, Part C (Medicare Advantage) is a private all-in-one plan that bundles A and B and usually drug coverage, and Part D is prescription drug coverage. A helpful memory trick: A and B are the government's "Original Medicare," while C and D are private plans that add to or repackage it. Most people end up using either A+B plus Part D, or a single Part C plan.
Do I have to do anything to get Medicare at 65?
It depends. If you're already drawing Social Security before 65, you're usually enrolled in Parts A and B automatically and get your card in the mail. If you're not yet drawing Social Security, you have to sign up yourself during your enrollment window. Either way, choosing your added coverage — a drug plan or a Medicare Advantage plan — is a separate, active decision. We help Sioux Falls area residents handle both at no cost.